Recently Lost MaineCare FAQ

During the COVID-19 pandemic, Congress passed a law that required all states to keep people covered by Medicaid (known in Maine as MaineCare) enrolled in the program even if they no longer qualified. This requirement, often referred to as the Medicaid continuous coverage requirement, ended on March 31, 2023. As a result, all states are reviewing eligibility of everyone enrolled in Medicaid and disenrolling individuals who are no longer eligible. The federal government is referring to this process as the “unwinding.” In Maine, the process of reviewing eligibility for everyone enrolled in MaineCare during the Covid-19 public health emergency will be carried out through the end of October 2024. CoverME.gov and MaineCare are working together to make sure you have an easy move to a new health plan. For more information, please visit mainecare.gov/unwinding.

MaineCare members who have not yet gone through the eligibility review process should take two important steps to stay covered:

1. Stay connected to stay covered! Update your current contact information with MaineCare, including address, email, and phone number. Members can call 1-855-797-4357 and press option 1 to update contact information through an automated system or visit MyMaineConnection.gov.
2. If it's blue, it's time to renew! Watch your mailbox for an envelope with a blue block on it, which contains the MaineCare renewal notice. Members who sign up for e-notices on My Maine Connection will receive their notices electronically and will not receive an envelope. Whether a member received their renewal form by mail or e-notice, they will need to complete and return it by the deadline stated in the notice. If Maine DHHS can verify your eligibility without further information from you, you will receive a notice that your coverage has been renewed for 12 months and you will not be required to fill out a renewal form. 

If you receive a notice that states you are no longer eligible for MaineCare coverage, you can enroll in CoverME.gov coverage through a Special Enrollment Period (SEP) called "Recently Lost MaineCare." Below are answers to frequently asked questions about how CoverME.gov can help you find affordable health insurance. If you do not find the answers to your questions below or need additional help, please call our Consumer Assistance Center at 1-866-636-0355 TTY: 711.

What do I do if I (or others in my household) lose MaineCare coverage because I (or others) am no longer eligible?

You can likely find affordable health coverage through CoverME.gov if you do not have access to health insurance from another source, such as through an employer. CoverME.gov is offering a Special Enrollment Period (SEP) for Marketplace-eligible consumers who are losing MaineCare due to the end of the Covid-19 public health emergency. CoverME.gov will be offering this self-service SEP from April 15, 2023 through December 31, 2024. During this time, most consumers who are losing MaineCare can access the Special Enrollment Period by creating or logging into their CoverME.gov account and selecting "Recently Lost MaineCare" from our list of Special Enrollment Periods. 

How do I know if I (or others in my household) am eligible to enroll on CoverME.gov?  

To determine if you or members of your household are eligible for CoverME.gov coverage, visit CoverME.gov and enter your information to create an account. In most cases, when the Office of Family Independence determines you or other members of your household are no longer eligible for MaineCare coverage, your information will be automatically and securely transferred to CoverME.gov, which will make it easier to complete your CoverME.gov application. 

What steps do I need to take to complete a CoverME.gov application? 

To complete an application, take the following steps:

1. Log in to your account or select "Create Account" if you don't have one already. To create a new account, you will need to set up a username and password and answer a few questions to confirm your identity. 
2. Once you create an account, you can review and update your application information and shop for health insurance plans. 

Do I need to wait until my MaineCare coverage ends before I can enroll on CoverME.gov? 

You do not have to wait for your MaineCare coverage to end before you apply on CoverME.gov. You should report the loss of coverage as soon as you know your MaineCare coverage is ending to avoid a gap in coverage. 

After I enroll on CoverME.gov, when will my coverage start?  

If you use the “Recently Lost MaineCare” Special Enrollment Period (SEP), your coverage will start the first of the month following the date you select a plan. For example, if you enroll in a plan on February 20, 2024, coverage will begin March 1, 2024. This Special Enrollment Period will not be available retroactively, so we encourage consumers to log in and select a plan as soon as possible. 

How long do I have to select a plan on CoverME.gov?  

If you are eligible for the “Recently Lost MaineCare” Special Enrollment Period (SEP), you will have 60 days after you report the Special Enrollment Period to select a Marketplace plan. Coverage starts the first day of the month after you select a plan. 

Is there a new application question that I must answer to be determined eligible for the temporary Special Enrollment Period?  

There is not a question on the application that you must answer to utilize the ”Recently Lost MaineCare” Special Enrollment Period. However, CoverME.gov has made updates to the existing application question in the “Health Coverage” section of the application that asks about a recent loss of MaineCare coverage. You will want to make sure that you answer that question so that CoverME.gov can accurately determine your eligibility for financial assistance.

Will I need to provide documentation to verify my eligibility to use the "Recently Lost MaineCare" Special Enrollment Period?  

You will not be required to submit documentation of a qualifying life event to be eligible for the “Recently Lost MaineCare” Special Enrollment Period on CoverME.gov. If completing the financial assistance application, you will be asked to report a loss of MaineCare coverage. 

What if I (or others in my household) lose MaineCare coverage, but don't report it to CoverME.gov within 60 days?  

Anyone who loses MaineCare coverage between April 15, 2023, and October 31, 2024, can use the “Recently Lost MaineCare” Special Enrollment Period to enroll in coverage prospectively on CoverME.gov. However, you should visit CoverME.gov to apply for and enroll in coverage as soon as you are found ineligible for MaineCare to avoid a gap in coverage. Coverage will begin at the beginning of the month after you select a plan. Coverage will not be applied for the months that have passed, even if you have a gap in coverage. 

How can I get help filling out the CoverME.gov application and enrolling in coverage?

You can call the CoverME.gov Consumer Assistance Center at 1-866-636-0355 TTY: 711 Monday through Friday, 8am to 5pm. The Consumer Assistance Center also has a live chat option available if you log in to your account on CoverME.gov. If you prefer in-person assistance, you can find free help in your community from a certified broker or Maine Enrolment Assister by visiting the Find Help Near You page. Many brokers and assisters also provide telephonic or video help. 

I currently have MaineCare coverage. What happens if I do not submit my renewal packet and/or verification documents by the due date? 

If you do not complete your renewal packet and/or don't provide requested verifications by the due date, your MaineCare coverage will end. You have 90 days from the date when your MaineCare coverage ends to complete your renewal to see if your coverage can continue.

Visit My Maine Connection to complete the renewal as soon as possible to avoid a gap in coverage. You may also call the Office for Family Independence at 1-855-797-4357 to complete your renewal over the phone.

If it has been more than 90 days, you must submit a new application. See how to apply. 

If I don't respond to my MaineCare renewal request and my MaineCare coverage ends, can I still enroll in CoverME.gov coverage? 

You may still apply for coverage through CoverME.gov if your MaineCare coverage ended by using the "Recently Lost MaineCare" Special Enrollment Period. If it looks like anyone in your household qualifies for MaineCare, we will send your information to the Office of Family Independence to determine eligibility for MaineCare. If no one in your household is assessed as eligible for MaineCare, you'll find out if you qualify for cost savings on a CoverME.gov plan. 

Will I be able to enroll on CoverME.gov after the "Recently Lost MaineCare" Special Enrollment Period ends? 

If you were unable to enroll on CoverME.gov because you did not receive a timely notice of termination of MaineCare coverage, you may contact the CoverME.gov Consumer Assistance Center at 1-866-636-0355 TTY: 711 to request a Special Enrollment Period, which will be granted on a case-by-case basis.